29 July 2022
During an inspection looking at part of the service
St Anne’s Community Services – The Crescent is a residential care home providing accommodation and personal care to up to 5 people, in one adapted building. The service provides support to people with learning disabilities and people who may be living with autism spectrum disorder. At the time of our inspection there were 5 people using the service.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support: Model of Care and setting that maximises people’s choice, control and independence
Support was provided to ensure people received their medication as prescribed however records in place did not always reflect best practice. We made a recommendation about this. The service gave people care and support in a well-furnished environment that met their sensory and physical needs. People had choice about their living environment and were able to personalise their rooms. Improvement is needed to ensure the cleanliness of the service meets a good standard; we made a recommendation about this and the registered manager took action to review their practice and improve. Staff supported people to take part in activities and pursue their interests however staff told us an increase in staffing would provide people with greater opportunities to access the community. People were supported by staff who knew them well and staff supported people to make decisions following best practice in decision-making. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Care: Care is person-centred and promotes people’s dignity, privacy and human rights
The service had enough staff to provide safe care however refresher training was needed to ensure staff practices were in line with best practice. People could communicate with staff and staff understood their individual communication needs however more work is needed to ensure all information within the service is accessible. We fed this back to the registered manager who planned improvements. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff promoted equality and diversity in their support for people. Relatives we spoke to were happy with the care provided; One relative said, “They just do a good job and [person] is happy.”
Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives
People’s care, treatment and support plans did not always reflect their range of needs and support required. However, staff turnover was low, which supported people to receive consistent care from staff who knew them well. The service did not have clear guidance on what people’s goals and aspirations were so these were not monitored however, staff worked with people to meet their aspirations. The service enabled people and those important to them to work with staff to develop the service. Staff placed people’s wishes, needs and rights at the heart of everything they did. One staff member said, “We want to ensure the people have the best quality of life.”
We received positive feedback from people and their family members about the service. One relative when speaking about the staff, told us, “They’re all good, and lovely to talk to.” Another relative said, “It’s just good, and I have no concerns at all because [person] is well cared for.”
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 24 January 2020) and there were breaches of regulation. At this inspection we found the provider remained in breach of regulations. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We carried out an announced comprehensive inspection of this service on 3 December 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the safety and governance of the service.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains as requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Anne’s Community Services – The Crescent on our website at www.cqc.org.uk.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to the safety and governance of the service at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.